“The Quality, Innovation, Productivity and Prevention (QIPP) collection is intended to be a resource for everyone in the NHS, public health and social care for making decisions about patient care or the use of resources.”

As part of NICE Evidence (National Institute for Clinical Excellence), this site is well worth exploring and encourages submissions from others. Here are some sample topics which give a flavour of the collection:

The rural geography of Cornwall means that many patients needed to travel for up to 1 hour to receive a dose of intravenous iron. This journey time increased during the summer because of the extra traffic caused by seasonal …

ThinkGlucose is designed to improve the care of people with diabetes when they are admitted to hospital. Patients with a secondary diagnosis of diabetes who receive the right care for their diabetes are able to return home fitter, more safely and ….

The QIPP Safe Care workstream launched its pilot, ‘Safety Express’, in January 2011. Over 1000 frontline staff in England worked collaboratively with a shared aim to deliver ‘harm-free’ care, defined as the absence of pressure ulcers, falls, …

Coordination and communication between hospital wards and team members has been a major issue locally and nationally. Standard pager and landline telephone systems are prone to delays. When pagers are answered, tasks must be interrupted to …

Small benefits of Z drugs over placebo for insomnia
A meta-analysis has found that Z drugs reduce the time taken to fall asleep by 22 minutes compared with placebo. However, this result may not be clinically significant and any benefit of Z drugs must be balanced against their well-documented risks.

Since you last received Eyes on Evidence our name has changed to the National Institute for Health and Care Excellence, to reflect our new role and responsibilities. NICE’s role is to improve outcomes for people using the NHS and other public health and social care services.

The prevalence of infectious diseases, such as tuberculosis, HIV and hepatitis C, in homeless populations is significantly higher than in the general population. However, figures show much local variation raising questions about the need for a more locally-based response.

Risk of abuse in disabled children A systematic review of studies from across the world suggests that more than a quarter of children with disabilities will experience abuse within their lifetimes and that children with disabilities are 3 to 4 times more likely to be victims of abuse than their peers without disabilities.

Rheumatoid factor and risk of future rheumatoid arthritis A cohort study reports that raised levels of rheumatoid factor are associated with an increased risk of developing rheumatoid arthritis. Although treating pre-rheumatoid is currently of unproven value, this study suggests it might be possible in the future.

Heart failure: effects of aldosterone antagonists and renin-angiotensin antagonists on mortality An observational study in people admitted to hospital with heart failure (HF) with reduced ejection fraction finds that aldosterone antagonists reduce readmissions for HF but have no effect on mortality and increase the risk of admission with hyperkalaemia. Another observational study in people with HF with preserved ejection fraction finds that angiotensin converting enzyme inhibitors or angiotensin receptor blockers reduced all-cause mortality.

Grapefruit–drug interactions A review article details the evidence for a pharmacokinetic interaction between grapefruit and certain drugs, and the potential clinical consequences of this.

The QIPP Collection highlights examples of local best practice, demonstrating how NHS organisations have implemented new practices that have both cut costs and improved quality. We highlight 2 new examples:

Analysis of data from a large randomised controlled trial suggests that intensive glucose control in critically ill patients is associated with moderate to severe hypoglycaemia, and a higher risk of death.

A cross-sectional study investigating a possible link between harsh physical punishment and mental health disorders reports that reducing physical punishment may help to reduce the prevalence of mental health disorders in the general population. It suggests giving parents information about alternative discipline strategies, such as positive reinforcement.

The QIPP Collection highlights examples of local best practice, demonstrating how NHS organisations have implemented new practices that have both cut costs and improved quality. We highlight a new example:

This paper is an assessment of current workforce issues and potential opportunities for improvement for the allied health workforce. It considers how best to organise this workforce across care pathways, considering factors such as optimum skill mix, education and leadership, and the QIPP toolkit. It is designed to support those who commission services and education, including local education and training boards.

Developing more integrated support for people with mental and physical health problems could improve outcomes, by recognising the role of emotional and mental health problems in reducing people’s ability and motivation to manage their physical health.

This systematic review provides good quality clinical evidence that angiotensin-converting enzyme inhibitors reduce the risk of death in patients with hypertension. The benefits of angiotensin receptor blockers in reducing mortality are uncertain.

Angiotensin receptor blockers (ARBs) are no better than placebo or angiotensin-converting enzyme inhibitors in reducing the risk of death, disability, or hospital admission for any reason. However, more patients stopped treatment early with ARBs than with placebo due to side effects.

An example from the Quality, Innovation, Productivity and Prevention collection on how the University Hospitals of Leicester NHS Trust has reduced delays, complications and costs around central venous access for patients.

The year 2011/12 launched today at the annual NHS Confederation Conference and Exhibition. This is the annual report for 2011/12, in which Sir David Nicholson reviews the NHS achievements of the previous 12 months and considers the challenges to come.

This edition includes the quarter, which provides the definitive account of how the NHS is performing at national level against the requirements and indicators set out in the NHS Operating Framework 2011/12.

In his introduction to the year (PDF, 3.9MB), Sir David acknowledges the hard work and diligence of NHS colleagues, with the service now fully committed to delivering the Quality, Innovation, Productivity and Prevention (QIPP) efficiency savings.

Against a backdrop of massive organisational change, Sir David praises, ‘the heroic efforts made by the 1.2 million staff who work for our patients in the NHS.’ Together, they have delivered key successes, including the lowest infection rates since the introduction of mandatory surveillance, lower waiting times for A&E, cancer care and dentistry, and the delivery of £5.8 billion efficiency savings.

Sir David acknowledges the efforts of GPs to begin driving clinically-led commissioning and the wider NHS engagement with the new public health agenda and the creation of the Health and Wellbeing Boards.

Although the Health and Social Care Bill has now passed through Parliament, Sir David reminds NHS colleagues of the hard work to come ‘to implement the transition from the old system to the new’. While acknowledging this ‘daunting challenge,’ he believes the annual report demonstrates strong foundations are in place to deliver further change for staff and patients.

The National End of Life Care Programme has published a suite of tools in conjunction with partner organisations designed to support end of life care commissioning and planning. These tools were developed to support organisations to achieve the vision of the National End of Life Care Strategy and the NHS QIPP agenda of improving quality and productivity through innovation. Together the tools are designed to enable commissioners and providers of end of life care services to identify the end of life care needs of their population over a 10-year period, to assess what workforce skills are required to ensure quality care provision and to establish how many people dying in hospital could reasonably end life in an alternative care setting and to calculate costings for this.

Although this information was published a couple of years ago, I include it here as an example of what is available on QIPP – which stands for Quality, Innovation, Productivity and Prevention

The NHS Institute supported Chief Executives and senior leadership to champion change and improvement across NHS organisations in all areas of the stroke pathway. Quality was improved by reducing mortality, time in A&E, and delay in CT. Read more at https://www.evidence.nhs.uk/qipp

My Shared pathway
My Shared pathway is part of the National Secure services Qipp Programme. It is developing a recovery approach to identifying and achieving outcomes and aims to streamilne the present pathway for service users in secure services.